Background Rectal manifestations of sexually transmitted infections (STIs) compromise the health of gay and bisexual men. In 2010 across 40 cities among men-who-have-sex-with-men (MSM) screened for STIs, anal swabbing was highest in London and Amsterdam with rates of more than 72%, but low across most other European cities. We repeated the comparison of diagnostic procedures for MSM across the same European cities, in order to see if in 2017 the gap between London/Amsterdam and other European cities has narrowed.

Methods We used data from the European MSM Internet Survey (EMIS-2017), a sexual health survey that was accessible online in 33 languages from 10/2017 to 01/2018. As sexual healthcare for MSM in most countries is organised locally, we chose cities for comparison and focus on a sub-sample of 38,439 men living the same 40 European cities. We applied multivariable regression models to compare the odds of having received anal swabbing in the 12 months, controlling for age, HIV diagnosis, and the number of sexual partners.

Results In 2017,the proportion of respondents tested for STIs in the previous 12 months in the absence of symptoms ranged from 19% in Belgrade to 59% in London. At individual level, compared to London, the Adjusted Odds Ratio (AOR) for having received anal swabbing ranged from 0.02 in Belgrade, Bucharest, and Istanbul (p<0.001) to 0.80 in Oslo (p<0.05), while no statistical significant difference was seen for Amsterdam and Dublin. Many Western European cities (Barcelona, Berlin, Brussels, Hamburg, Lisbon, Munich, Paris, Porto, Prague, Valencia, Zurich) have substantially narrowed their performance distance to London, but many Eastern European cities (Kiev, Riga, Sofia, St.Petersburg, Tallinn) have moved even further away since 2010.

Conclusion Although comprehensive STI-screening in gay and other MSM has increased across many European cities, rectal STIs continue to be under-diagnosed, particularly in Eastern Europe.

Disclosure No significant relationships.